Vulnerabilidade de gênero para a paternidade em homens adolescentes Gender vulnerability for parenthood among male adolescents

OBJETIVO: Analisar as relações de gênero vivenciadas por adolescentes do sexo masculino e como elas contribuem para torná-los vulneráveis à gravidez na adolescência. MÉTODOS: Estudo qualitativo realizado em Campo Grande, Mato Grosso do Sul, em 2003. Participaram 13 adolescentes masculinos com menos de 20 anos, com um único filho de até 11 meses, cuja mãe estava na mesma faixa etária do pai. Realizaram-se entrevistas semi-estruturadas gravadas. Após transcrição, procedeu-se à análise temática de conteúdo. RESULTADOS: Identificaram-se estereótipos de gênero em que se destacavam papéis de líder, provedor e ativo sexualmente, bem como a rejeição a ser cuidador. Esses papéis apareceram consolidados principalmente na perspectiva dos entrevistados acerca do trabalho como marcador de sua condição de homem e provedor da família. A liderança dos adolescentes prevaleceu no relacionamento com a mãe de seu filho, notadamente na iniciativa das relações sexuais e no uso de contraceptivos. A gravidez foi considerada por eles como "por acaso" e inesperada, mas a paternidade foi vivenciada como uma prova final de sua condição de homens adultos. CONCLUSÕES: Verificou-se a condição de vulnerabilidade dos adolescentes para a paternidade em virtude da socialização de gênero nos moldes tradicionais. Isso foi evidenciado com a ausência dos papéis relativos ao cuidado consigo próprio e com os outros, com a incorporação precoce de papéis de dominação sexual masculina e de trabalhador e pai, ou seja, deixar de ser criança e alcançar a condição de homem.<br>OBJECTIVE: To analyze gender relations perceived by male adolescents and how they contribute to making them more vulnerable to pregnancy during adolescence. METHODS: Qualitative study carried out in Campo Grande, Midwestern Brazil, in 2003. Subjects were 13 male adolescents under 20 years of age, fathers of an only child aged up to 11 months whose mother was in the same age group as them. Semi-structured interviews were carried out, tape recorded and transcribed. Thematic content analysis was carried out. RESULTS: Gender stereotypes were identified in which the role of leader, provider, and sexually active was stressed and the role of caregiver was rejected. These roles seemed consolidated especially in the subjects' perspective regarding paid employment as a marker of their male condition as well as of a family provider. Adolescents' leadership prevailed in the relationship with the mother of their child especially in taking initiative in sexual intercourse and the use of contraceptives. They considered that pregnancy was unexpected and happened "by chance". However, fatherhood was experienced as a definite evidence of their status as adult men. CONCLUSIONS: Male adolescents showed to be vulnerable to fatherhood due to gender socialization following traditional patterns. This was evidenced by the inexistence of roles related to self care and care for others, and early playing roles of male sexual dominance, of father and family provider in order to grow up and become a man

Towards an epidemiologic definition of renal disease: Rates and associations of albuminuria in a high-risk Australian Aboriginal community

An epidemic of renal failure is accompanying the rising rates of hypertension, type 2 diabetes and cardiovascular disease among Aborigines in the Northern Territory of Australia. The rates and associations of the underlying renal disease were studied in a remote Aboriginal community whose renal failure rates are among the highest reported in the world. More than 90% of school-age children and adults participated in a health screen, in which the urinary albumin/creatinine ratio (ACR) was used as the primary renal disease marker. Albuminuria was evident in early childhood and increased dramatically with age; 26% of adults had microalbuminuria and 24% had overt albuminuria. Most hypertension segregated in persons with albuminuria and all renal failure developed out of a background of overt albuminuria. ACR levels correlated with the presence of scabies at screening, with a history of post-streptococcal glomerulonephritis, with increasing bodyweight or its surrogates, with increasing blood pressure, glucose, insulin and lipid levels, and with evidence of heavy drinking. ACR also correlated inversely with birthweight. Finally, increasing ACR correlated with an increasing cardiovascular risk factor score. Thus many factors contribute to renal disease in this community; most are the features and consequences of lifestyle change, poverty and disadvantage. Renal disease shares risk factors, including low birthweight, with Syndrome X, which supports the inclusion of renal disease in that syndrome, and explains the excess cardiovascular morbidity in people with chronic renal disease. There is an urgent need for effective programs to modify recognized risk factors, and to identify and treat people with established renal disease to retard the progression of renal insufficiency